Predicting outcome in patients with rhabdomyosarcoma: Role of [18F]fluorodeoxyglucose positron emission tomography Journal Article

Authors: Casey, D. L.; Wexler, L. H.; Fox, J. J.; Dharmarajan, K. V.; Schoder, H.; Price, A. N.; Wolden, S. L.
Article Title: Predicting outcome in patients with rhabdomyosarcoma: Role of [18F]fluorodeoxyglucose positron emission tomography
Abstract: Purpose To evaluate whether [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) response of the primary tumor after induction chemotherapy predicts outcomes in rhabdomyosarcoma (RMS). Methods and Materials After excluding those with initial tumor resection, 107 patients who underwent FDG-PET after induction chemotherapy at Memorial Sloan Kettering Cancer Center from 2002 to 2013 were reviewed. Local control (LC), progression-free survival (PFS), and overall survival (OS) were calculated according to FDG-PET response and maximum standardized uptake value (SUV) at baseline (PET1/SUV1), after induction chemotherapy (PET2/SUV2), and after local therapy (PET3/SUV3). Receiver operator characteristic curves were used to determine the optimal cutoff for dichotomization of SUV1 and SUV2 values. Results The SUV1 (<9.5 vs ≥9.5) was predictive of PFS (P=.02) and OS (P=.02), but not LC. After 12 weeks (median) of induction chemotherapy, 45 patients had negative PET2 scans and 62 had positive scans: 3-year PFS was 72% versus 44%, respectively (P=.01). The SUV2 (<1.5 vs ≥1.5) was similarly predictive of PFS (P=.005) and was associated with LC (P=.02) and OS (P=.03). A positive PET3 scan was predictive of worse PFS (P=.0009), LC (P=.05), and OS (P=.03). Conclusions [18F]fluorodeoxyglucose positron emission tomography is an early indicator of outcomes in patients with RMS. Future prospective trials may incorporate FDG-PET response data for risk-adapted therapy and early assessment of new treatment regimens.
Keywords: adult; treatment outcome; treatment response; middle aged; cancer surgery; major clinical study; overall survival; doxorubicin; cancer radiotherapy; chemotherapy; positron emission tomography; carboplatin; progression free survival; etoposide; cyclophosphamide; vincristine; retrospective study; ifosfamide; risk assessment; irinotecan; tumors; fluorodeoxyglucose f 18; rhabdomyosarcoma; electrons; predictive value; induction chemotherapy; positrons; receiver operating characteristic; standardized uptake value; radiological parameters; predicting outcomes; cancer prognosis; methods and materials; maximum standardized uptake values; human; male; female; article; fluorodeoxyglucose-positron emission tomographies; receiver operator characteristic curves
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 90
Issue: 5
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2014-12-01
Start Page: 1136
End Page: 1142
Language: English
DOI: 10.1016/j.ijrobp.2014.08.005
PROVIDER: scopus
PUBMED: 25539372
Notes: Export Date: 2 February 2015 -- Source: Scopus
Citation Impact
MSK Authors
  1. Josef J Fox
    53 Fox
  2. Suzanne L Wolden
    448 Wolden
  3. Leonard H Wexler
    145 Wexler
  4. Heiko Schoder
    316 Schoder
  5. Alison Nicole Price
    4 Price
  6. Dana   Casey
    39 Casey